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  1. This Summary Plan Description (SPD) provides PEIA PPB Plan participants with an easy-to- read description of benefits available through the Plans and instructions on how to use these benefits.

  2. This Summary Plan Description (SPD) provides PEIA PPB Plan participants with an easy-to-read description of benefits available through the Plans and instructions on how to use these benefits. The SPD is a summarized version of a portion of PEIA’s Plan Document. The Plan Document describes, in detail, all aspects of the operations of the

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  3. 3. Check page 12 to be sure you’re eligible to enroll in the plan you want. The PEIA PPB Plans A, B and C are available in all areas. PEIA PPB Plan D is open to WV residents only and covers only services provided in WV. The Health Plan is available in all West Virginia counties. If you live

  4. Benefit Description PEIA PPB Plan A In-Network PEIA PPB Plan A Out-of-Network Rehabilitation* Deductible + 20% $500 + Deductible + 40% + amounts that exceed PEIA’s fee

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  5. Employee Benefits. After completing the PEIA benefits enrollment online through the PEIA website, complete the basic life and optional life insurance beneficiary for m on the MetLife website by clicking here . Please provide the completed form to the HR coordinator for processing.

  6. When services are limited to a maximum number of days, treatments, visits, etc., each visit, treatment, etc. must be medically necessary and appropriate to be covered. 1.888.847.7902 | www.healthplan.org.

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  8. Eligible dependents include your after your 2022 plan year ends to submit reimbursement qualifying child up to age 13, your spouse and/or relative requests for all eligible FSA expenses incurred DURING your unable to care for him or herself.

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